- •Comprehensive Postacute Stroke Services (COMPASS) is a large pragmatic trial of comprehensive postacute stroke services.
- •The Movement Matters Activity Program (MMAP) is a key COMPASS model intervention.
- •The MMAP promotes evidence-based poststroke rehabilitative care in the community.
- •The MMAP implementation in home health and outpatient therapy was highly variable.
- •Keys to success: empowered leaders, informed clinicians, value-based care emphasis.
List of abbreviations:APP (Advanced Practice Provider), CFIR (Consolidated Framework for Implementation Research), COMPASS (Comprehensive Postacute Stroke Services), COMPASS-CP (Comprehensive Postacute Stroke Services Care Plan), CMS (Centers for Medicare and Medicaid Services), EBP (evidence-based practice), MMAP (Movement Matters Activity Program), PAC (postacute care), TC (transitional care), TIA (transient ischemic attack)
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- Heart disease and stroke statistics-2019 update: a report from the american heart association.Circulation. 2019; 139: e56-528
- The comprehensive post-acute stroke services (compass) study: design and methods for a cluster-randomized pragmatic trial.BMC Neurol. 2017; 17: 133
- Persisting consequences of stroke measured by the Stroke Impact Scale.Stroke. 2002; 33: 1840-1844
- Bouncing-back: rehospitalization in patients with complicated transitions in the first thirty days after hospital discharge for acute stroke.Home Health Care Serv Q. 2007; 26: 37-55
- Bouncing back: patterns and predictors of complicated transitions 30 days after hospitalization for acute ischemic stroke.J Am Geriatr Soc. 2007; 55: 365-373
- Association of rehabilitation intensity for stroke and risk of hospital readmission.Phys Ther. 2015; 95: 1660-1667
- Influence of hospital-level practices on readmission after ischemic stroke.Neurology. 2014; 82: 2196-2204
- Balance, falls, and bone health: role of exercise in reducing fracture risk after stroke.J Rehabil Res Dev. 2008; 45: 297-313
- Fall-related self-efficacy, not balance and mobility performance, is related to accidental falls in chronic stroke survivors with low bone mineral density.Osteoporos Int. 2008; 19: 919-927
- Stroke rehabilitation patients, practice, and outcomes: is earlier and more aggressive therapy better?.Arch Phys Med Rehabil. 2005; 86: S101-S114
- Dose and timing in neurorehabilitation: prescribing motor therapy after stroke.Curr Opin Neurol. 2015; 28: 549-555
- Community use of physical and occupational therapy after stroke and risk of hospital readmission.Arch Phys Med Rehabil. 2018; 99: 26-34
- Contemporary trends and predictors of postacute service use and routine discharge home after stroke.J Am Heart Assoc. 2015; 4e001038
- Physical and occupational therapy from the acute to community setting after stroke: predictors of use, continuity of care, and timeliness of care.Arch Phys Med Rehabil. 2018; 99: 1077-1089
- Compass-CP: an electronic application to capture patient-reported outcomes to develop actionable stroke and transient ischemic attack care plans.Circ Cardiovasc Qual Outcomes. 2018; 11e004444
- A person-centered approach to poststroke care: the comprehensive post-acute stroke services model.J Am Geriatr Soc. 2018; 66: 1025-1030
- Does home blood pressure monitoring improve patient outcomes? A systematic review comparing home and ambulatory blood pressure monitoring on blood pressure control and patient outcomes.Integr Blood Press Control. 2015; 8: 43-49
- Randomized pragmatic trial of stroke transitional care: the Compass Study.Circ Cardiovasc Qual Outcomes. 2020; 13e006285
- A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project.Implement Sci. 2015; 10: 21
- Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.Implement Sci. 2009; 4: 50
- Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association.Stroke. 2014; 45: 2532-2553
- A self-administered Graded Repetitive Arm Supplementary Program (GRASP) improves arm function during inpatient stroke rehabilitation: a multi-site randomized controlled trial.Stroke. 2009; 40: 2123-2128
- Does the ‘Otago Exercise Programme' reduce mortality and falls in older adults?: a systematic review and meta-analysis.Age Ageing. 2010; 39: 681-687
- Disseminating the Otago Exercise Program in the United States: perceived and actual physical performance improvements from participants.J Appl Gerontol. 2018; 37: 79-98
- Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial.BMJ. 2012; 345: e4547
- CDC's approach to make older adult fall prevention part of every primary care practice.J Safety Res. 2017; 63: 105-109
- COMPASS movement matters provider handout.(Available at:)https://www.nccompass-study.org/wp-content/uploads/2019/06/COMPASS-MM-v2-1.pdfDate accessed: October 12, 2020
- COMPASS insurance matters underinsured patient handout.(Available at:)https://www.nccompass-study.org/wp-content/uploads/2019/05/Insurance-Matters-Uninsured-for-patients-v9CR.pdfDate accessed: October 12, 2020
- COMPASS home health quality reporting provider handout.(Available at:)https://www.nccompass-study.org/wp-content/uploads/2019/06/HH-quality-metricsCR2.pdfDate accessed: October 12, 2020
- Movement matters training grid - home health and outpatient therapy providers.(Available at:)https://www.nccompass-study.org/wp-content/uploads/2019/06/HHOP-Training-Grid_2.pdfDate accessed: October 12, 2020
- CFIR simplified: pragmatic application of and adaptations to the Consolidated Framework for Implementation Research (CFIR) for evaluation of a patient-centered care transformation within a learning health system.Learn Health Syst. 2020; 4e10201
- Qualitative data. Consolidated framework for implementation research. 2020 (Available at: https://cfirguide.org/. Accessed August 30, 2020)
- COMPASS model of care - checklist for home health and outpatient therapy providers.(Available at:)https://www.nccompass-study.org/wp-content/uploads/2019/06/homehealth-checklist-final-2.pdfDate accessed: October 12, 2020
- The answer is 17 years, what is the question: understanding time lags in translational research.J R Soc Med. 2011; 104: 510-520
- From best evidence to best practice: effective implementation of change in patients' care.Lancet. 2003; 362: 1225-1230
- Facilitated interprofessional implementation of a physical rehabilitation guideline for stroke in inpatient settings: process evaluation of a cluster randomized trial.Implement Sci. 2017; 12: 100
- Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review.Syst Rev. 2018; 7: 72
- Knowledge translation of research findings.Implement Sci. 2012; 7: 50
- Making sense of complexity in context and implementation: the Context and Implementation of Complex Interventions (CICI) framework.Implement Sci. 2017; 12: 21
- Designing and evaluating complex interventions to improve health care.BMJ. 2007; 334: 455-459
- Developing and evaluating complex interventions: the new Medical Research Council guidance.BMJ. 2008; 337: a1655
- Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used.Transl Behav Med. 2018; 8: 212-224
- Delivering intensive rehabilitation in stroke: factors influencing implementation.Phys Ther. 2018; 98: 243-250
- Implementing a complex rehabilitation intervention in a stroke trial: a qualitative process evaluation of AVERT.BMC Med Res Methodol. 2016; 16: 52
- What roles do middle managers play in implementation of innovative practices?.Health Care Manage Rev. 2017; 42: 14-27
- Stakeholder engagement to identify priorities for improving the quality and value of critical care.PLoS One. 2015; 10e0140141
- Using ‘linkage and exchange' to move research into policy at a Canadian foundation.Health Aff (Millwood). 2000; 19: 236-240
- Development of a behaviour change intervention to increase upper limb exercise in stroke rehabilitation.Implement Sci. 2015; 10: 34
- Physical therapists' treatment choices for non-specific low back pain in Florida: an electronic survey.J Man Manip Ther. 2015; 23: 109-118
- A qualitative application of the diffusion of innovations theory to examine determinants of guideline adherence among physical therapists.Phys Ther. 2009; 89: 221-232
- Clinical specialization and adherence to evidence-based practice guidelines for low back pain management: a survey of US physical therapists.J Orthop Sports Phys Ther. 2017; 47: 347-358
- Using behavorial science to improve survey response: an experiment with the national beneficiary survey.Mathematica Policy Research, Princeton2017
- The use and effects of incentives in surveys.Ann Am Acad Pol Soc Sci. 2013; 645: 112-141
- Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity.BMC Med Res Methodol. 2003; 3: 28
- Pragmatic trials.N Engl J Med. 2016; 375: 454-463
- CCTP final evaluation report: evaluation of the community-based care transitions program.(Available at:)https://innovation.cms.gov/innovation-models/cctpDate accessed: August 30, 2020
- Changes in health care costs and mortality associated with transitional care management services after a discharge among Medicare beneficiaries.JAMA Intern Med. 2018; 178: 1165-1171
- A theory of organizational readiness for change.Implement Sci. 2009; 4: 67
- The knowledge broker's "fit" in the world of knowledge translation.Physiother Can. 2014; 66: 223-227
- Implementation support practitioners - a proposal for consolidating a diverse evidence base.BMC Health Serv Res. 2020; 20: 368
- Transitional care management services fact sheet.(Available at:)https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Transitional-Care-Management-Services-Fact-Sheet-ICN908628.pdfDate accessed: September 26, 2019
Supported by the Patient-Centered Outcomes Research Institute (PCORI) Project Program Award (no. PCS-1403-14532). All statements in this presentation, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of PCORI, its Board of Governors, or its Methodology Committee.
Clinical Trial Registration No.: NCT0258866.
Disclosures: Drs Duncan, Bushnell, and D'Agostino report ownership interest in Care Directions Inc. The other authors have nothing to disclose.